ABSTRACT
Results of the comparative analysis of structural changes in cardiomyocyte sarcomers revealed by polarization microscopy in certain fatal cases. The main causes of impaired cardiac contractility and cardiac arrest in the victims of craniocerebral injury and in the subjects with acute forms of ischemic heart disease (acute coronary artery insufficiency and acute myocardial infarction in the pre-necrotic phase), pneumonia, or mechanical strangulation asphyxia (resulting from hanging, with the loop placed around the anterior upper third of the neck and the knot in the posterolateral aspect).
Subject(s)
Heart Diseases/pathology , Myocardial Contraction , Myocardium/pathology , Sarcomeres/pathology , Craniocerebral Trauma/pathology , Forensic Pathology/methods , Humans , Microscopy, Polarization/methodsABSTRACT
Dynamics of postmortem autolysis of cardiocytes was evaluated using cells and tissues obtained from the patients who died from acute forms of ischemic heart disease, such as acute coronary insufficiency and acute myocardial infarction in the pre-necrotic phase. The studies were carried out at a temperature of 7, 20, and 37 degrees C. It was shown that autolysis of cardiac muscular fibers proceeds through three successive stages. A rise in temperature from 7 to 20 degrees C accelerated autolysis by one third while further elevation of the temperature up to 37 degrees C was associated with a 9-fold decrease in the duration of autolysis.
Subject(s)
Autolysis/pathology , Heart Diseases/pathology , Postmortem Changes , Female , Humans , Male , Middle Aged , Myocytes, Cardiac , Time FactorsABSTRACT
We studied morphological changes of myocardium and content of glucose, potassium, calcium, sodium in pericardial fluid in persons who died suddenly of myocardial infarction at its prenecrotic stage at prehospital phase. It was established that acute myocardial infarction at prenecrotic stage can run in 2 morphological forms - either with transmural or with subendo- or epicardial localization of ischemic process in left ventricular wall. Transmural injury is characterized by large volume of ischemic damage of the left ventricle, generalized spasm of arterial system of the heart, changes of cardiomyocytes with derangement of their energy metabolism and contractile capacity. In subendo- or epicardial localization foci of ischemic injury alternated with areas of normal blood supply. Similar character of disturbances of rheological properties of blood with thrombosis of microcirculatory bed and of number of markers of ventricular fibrillation between these two forms create preconditions for increase of the zone of necrosis in myocardium and cause high risk of development of rhythm disorders.
Subject(s)
Myocardial Infarction/pathology , Myocardium/pathology , Pericardial Effusion/chemistry , Cadaver , Female , Glucose/analysis , Humans , Male , Microscopy, Polarization , Middle Aged , Myocardial Infarction/complications , Myocardial Infarction/metabolism , Necrosis , Pericardial Effusion/etiology , Potassium/analysis , Severity of Illness Index , Sodium/analysis , Spectrophotometry, AtomicABSTRACT
It is generally accepted that an optimal control group for pathomorphological studies of the heart should be constituted by individuals who died from a craniocerebral injury without near-death experience. Polarization microscopy is a principal tool for the assessment of pathomorphological characteristics of myocardium. The presence of ethanol in the blood of a dead individual is associated with enhanced permeability of vascular walls, venous plethora, sludge phenomenon, microcirculatory thrombosis, perivascular and intermuscular oedema but does not on the whole interfere with the objective evaluation of microscopic images of the cardiac muscle.
Subject(s)
Control Groups , Forensic Pathology/methods , Forensic Pathology/standards , Myocardium/pathology , Adolescent , Adult , Aged , Asphyxia/pathology , Cause of Death , Craniocerebral Trauma/pathology , Female , Humans , Male , Microscopy, Polarization , Middle Aged , Myocardial Ischemia/pathology , Young AdultABSTRACT
We studied morphological changes in the myocardium and content of glucose, magnesium, calcium, sodium in pericardial fluid of victims of out of hospital sudden death due to acute coronary insufficiency and prenecrotic stage of myocardial infarction. We established that both in regions of ischemic injury appearing as III degree contracture lesions of cardiomyocytes, zones of intracellular myocytolysis and primary breakdown of myofibrils, as will as in zones of relaxation myocardium loses its contractile properties. This in turn leads to asynchronous contraction of left and right ventricles. As fibrillation develops in both ventricles simultaneously there are all grounds to believe that morphological prerequisite (source of origin) of fibrillation is the presence of areas of ischemic injury and relaxation in the myocardium.
Subject(s)
Death, Sudden, Cardiac/pathology , Heart Ventricles/pathology , Myocardium/pathology , Ventricular Fibrillation/pathology , Blood Glucose/metabolism , Calcium/metabolism , Female , Humans , Male , Mass Spectrometry , Microscopy, Polarization , Middle Aged , Myocardium/metabolism , Myocytes, Cardiac/pathology , Pericardial Effusion/metabolism , Sodium/metabolism , Ventricular Fibrillation/etiology , Ventricular Fibrillation/metabolismABSTRACT
The informative value of the levels of calcium, potassium, sodium, magnesium, and glucose was estimated in individuals who had suddenly died from acute coronary insufficiency or acute myocardial infarction in the prenecrotic phase. The informational variations in the concentrations of electrolytes and glucose were found to reflect the differences available in the pathogenesis of an ischemic process in acute coronary insufficiency and acute myocardial infarction in the prenecrotic phase.
Subject(s)
Body Fluid Compartments , Coronary Disease/metabolism , Electrolytes/metabolism , Glucose/metabolism , Pericardium/metabolism , Acute Disease , Adolescent , Adult , Female , Humans , Male , Middle Aged , Myocardial Infarction/metabolismABSTRACT
The informative worth of sodium, potassium, calcium, magnesium, glucose, and urea levels in the pericardial liquid is analysed. The values of these parameters in a terminal disease of cerebral origin may testify to the absence of disturbances of energy and protein metabolism or electrolyte disbalance in the myocardium. Disturbances of myocardial electrolyte balance, energy and protein metabolism develop in cardiac, pulmonary, and mixed type terminal conditions. Cardiac arrest is associated with impaired myocardial conduction.
Subject(s)
Body Fluid Compartments , Electrolytes/analysis , Forensic Pathology , Glucose/analysis , Pericardium/pathology , Urea/analysis , Adolescent , Adult , Aged , Aged, 80 and over , Cadaver , Cause of Death , Diagnosis, Differential , Electrolytes/metabolism , Energy Metabolism , Female , Glucose/metabolism , Humans , Male , Middle Aged , Pericardium/metabolism , Predictive Value of Tests , Urea/metabolism , Water-Electrolyte Balance , Young AdultABSTRACT
The death from acute ischemic heart diseases (acute coronary insufficiency (n = 39) and acute myocardial infarction (n = 36) is accompanied by a slight increase in the thickness of the left ventricular wall with preserved normal heart weight. Microscopically, there are longer intermuscular distances, cardiomyocytic thickening, nuclear polymorphism, contractures, and destruction of myocytes and their lysis.
Subject(s)
Death , Myocardial Infarction/pathology , Myocardial Ischemia/pathology , Myocardium/pathology , Adult , Aged , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Ischemia/diagnosisABSTRACT
The postmortem diagnostics of acute forms of coronary heart disease showed that third-degree cardiomyocytic damages, primary lumpish destruction, and intracellular myocytolysis are attended by elevated cardiac troponin I levels in pericardial fluid and by enhanced activity aspartate aminotransferase and lactate dehydrogenase.
Subject(s)
Aspartate Aminotransferases/analysis , Coronary Disease/pathology , L-Lactate Dehydrogenase/analysis , Pericardial Effusion/chemistry , Troponin I/analysis , Adult , Aged , Biomarkers/analysis , Female , Humans , Male , Middle AgedABSTRACT
A statisticomathematical analysis of microscopic changes in the myocardium has established pathognomonic and differential-diagnostic morphological signs for diagnosis of acute ischemic heart disease--acute coronary failure and acute myocardial infarction at the prenecrotic stage. The results of chromotrop 2B water blue staining of histological preparations and polarization microscopy were compared.
